| NPI | 1649526674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 78284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266020-1) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2024-07-18 |